Histories
Histories is a first season episode of House which first aired on February 8, 2005. Wilson is convinced a homeless Jane Doe in the emergency room has a real illness, but Foreman is convinced she’s faking symptoms to stay in the hospital. House takes the case just to spite Foreman, but even when they find who she is and what’s wrong with her, the treatment makes her worse. Recap A woman begs to be taken into a rave party, but doesn't have the money. She pleads to find a man named James, and the doorman agrees. She is confused by the flashing lights, repeatedly calling James. A woman helps her find him, but kisses her. Another woman pushes her aside and police raid the party. She knocks over the policeman arresting the woman who pushed the gay woman aside, and falls to the floor, having a seizure. She is taken to Princeton-Plainsboro where she is admitted as a Jane Doe. Wilson tells Foreman that although they suspected her condition was a drug overdose, her tox screen was clean. Foreman believes she might have a mental illness. They examine the patient and Foreman feels that she is faking symptoms. The patient has a seizure which turns out to be the result of low blood sugar. She is also displaying a twitch and can't remember who she is. Foreman still feels that she's faking it and wants to discharge her. Wilson goes to House to tell him that he thinks the patient has a real problem. House wonders why Wilson is so interested in the patient and takes the case. The team does a differential, and Foreman still thinks she's faking it. House believes it's important to find out who she is. He starts going through her meagre possessions. He also points out that without memories, she can't give them a medical history. By looking at her possessions, House feels she might have an electrolyte imbalance. House tells Foreman he's taking the case because Foreman doesn't want him to. The patient is making drawings of the doctors. Chase speaks to the patient and tells her Foreman doesn't like him either. She goes into a rage while Chase treats her and bites Foreman. Chase notes she's negative for HIV and Hepatitis C. Foreman tries to bump another patient to give the patient an MRI so he can discharge her, but Cuddy finds out about the attempt. Cuddy points out that the CT scan showed the patient has a metal pin in her arm and can't undergo an MRI. She agrees to let them remove the pin because House tells her Foreman believes it is a brain tumor. Foreman goes out to look for where the patient was living. He trades his jacket to a homeless man to find out, and finds the patient's tent filled with bats. He also finds some papers. The MRI is negative, but House admits he only took out the pin so that he could identify the patient (the pins have serial numbers that are tied to the patient‘s name). Most of the papers found are drawings made by the patient. The patient's name is Victoria Madsen. Her medical records start coming in, the first of which shows she’s allergic to the anemia medication they are giving her. The patient suffers a severe allergic reaction. They inject her with epinephrine. However, they still can't determine what might be wrong with her despite finding her old hospital records. Wilson thinks that they might have been looking for ovarian cancer. House notes that paraneoplastic syndrome might account for the twitch and orders them to scan her ovaries. House dodges clinic duty by faking a cold. House discusses with Foreman why he doesn't like homeless people. He also asks Wilson why he cares so much about the patient. Cuddy gets back at House for dodging clinic duty by assigning him two students to teach them about medical histories. House sends them to the patient they've been assigned to. House still wonders why Foreman doesn't like homeless people. Wilson wonders why House cares. They find a mass on her ovary. If it is cancer, the patient will not live. House tells them to treat for tuberculosis on the off chance that it’s a tuberculoma - they can't do anything for ovarian cancer. Foreman apologizes to the patient for not believing she was ill. She apologizes too - she took too much insulin to get into hospital. The patient starts complaining that the lights are too bright. She also has a fever of 105F. She spits out the water she is given, complaining it tastes like poison. Foreman wants to rule out tuberculosis as the treatment isn't working, but the biopsy shows that the mass is a tuberculoma, confirming tuberculosis. House wonders why the diagnosis is right and the treatment for it is making her worse. Chase, Wilson and Foreman start arguing. House orders a chest x-ray and they put the patient in an ice bath to reduce her fever. However, the patient is still terrified of the water. Meanwhile, the students report back to House. One says the patient hurt her wrist when she fell off her horse. The other says that she did it when she fell off her porch. House asks what the patient's weight is and what color her nose is. The patient is either under 90 pounds or has a red nose. The students realize that House knows whats wrong and ask him what it is. He hands them a huge neurology textbook and tells them it starts with "C". The team has discovered she has an infection, most likely meningitis. House orders treatment for it. However, they find the patient, who was sedated, is not in her room. Wilson thinks Foreman screwed up and didn‘t properly sedate the patient. Cuddy tells them to phone the police. The students report back to House. They are guessing. House talks to the patient, a slight young teenager. She tells him he hurt her wrist when she swung at a bird but hit a ferris wheel. House tells the students its Korsakoff's syndrome. The patient is using clues to try to fill in gaps in her memory, but can't actually remember what happened. The students point out that Korsakoff starts with a "K". House tells them to treat everyone like they have it, as everybody lies. He tells them to put her on thiamine and give her some food. The police recover the patient, who has collapsed and has heart arhythmia. House thinks it is still meningitis. The police tell House that she was lying on the grass. House figures out that the police used their taser on her, which caused the arhythmia. Despite the treatment, the patient is getting worse. House also notes that the patient didn't respond to the first taser shot to her thigh. She turns out not to have any sensation there. Foreman thinks its diabetes mellitus. However, House jabs a needle where the patient bit Foreman, and Foreman doesn't show any reaction until he sees the needle. The numbness, paranoia, ineffectiveness of sedatives, hydrophobia, disorientation and sensitivity to light point to only one thing - rabies, most likely from bats. The disease has progressed too far and there is nothing they can do. However, Foreman needs to have immediate treatment. Foreman and Wilson out to look for the man the patient was referring to - James. He finds her old apartment, now abandoned. They find out that “Mr. Fury” in her comic books was her husband Paul Furia. James was her son, who died along with her husband during the car crash where she received her surgical pin. It becomes obvious that after the car crash she couldn't cope and became homeless. Foreman returns to Victoria and tells her that her husband and James forgive her. She dies peacefully. House once again confronts Wilson about why he fought so hard for the patient. He finds out for the first time that Wilson has a brother who is homeless and he hasn't seen in nine years. Medical Errors When Foreman is treated for rabies, the shot is given in his abdomen. Although this was once the way rabies vaccine was given, nowadays rabies vaccine is generally given in the muscle of the upper arm, which is far less painful. Had Foreman actually been far enough along in the disease's progression to not be feeling sensation at the site of the bite injury, the disease would most likely have been untreatable. Hydrophobia is not “fear of water”, but the phenomena where the body starts rejecting water from its tissues. It causes the “foaming at the mouth” seen in rabid animals. Zebra Factor 8/10 In 2005, there was only 1 human case of rabies in the United States. During 1980--2004, a total of 56 cases of human rabies were reported in the United States. Among the 55 cases for which rabies-virus variants were obtained, 35 (64%) were associated with insectivorous bats. Worldwide, the World Health Organization estimates that approximately 55,000 people die from rabies each year - mostly in Africa and Asia, and mostly from dog rabies. Trivia & Cultural References *Mental illness is one of the major contributing factors to homelessness. *When Foreman replies that the treatment for advanced ovarian cancer is a “pine box”, he is referring to an inexpensive type of casket, often used to bury the destitute. *The massive textbook House hands the medical students is Adams and Victor’s Principles of Neurology by Allan Ropper and Robert Brown. It is a genuine medical text. *A Taser is a weapon that delivers an electric shock that causes loss of voluntary muscle control. Major Events * We find out about Foreman’s family for the first time - that his mother and father are still married and have been for forty years. * Wilson tells House that he has two brothers, one of whom is homeless and who he hasn't seen in nearly nine years. Starring * Jesse Spencer as Dr. Robert Chase * Jennifer Morrison as Dr. Allison Cameron * Robert Sean Leonard as Dr. James Wilson * Hugh Laurie as Dr. Gregory House * Omar Epps as Dr. Eric Foreman * Lisa Edelstein as Dr. Lisa Cuddy